Cortical echogenicity is the sonographic parameter that correlates best with renal histopathology. Although size or echogenicity alone are poor predictors of chronic irreversible disease, the likelihood of treatable disease in small kidneys with increased cortical echogenicity is very low.

Background-Atrial fibrillation (AF) is common among patients with end-stage renal disease, but few data are available on its prevalence among adults with chronic kidney disease (CKD) of lesser severity. Methods and Results-We evaluated the association of CKD with ECG-detected AF among 26 917 participants in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, a population-based cohort of African-American and white US adults Ն45 years of age. Estimated glomerular filtration rate (eGFR) was calculated using the abbreviated Modification of Diet in Renal Disease study equation and albuminuria was defined as a urinary albumin to creatinine ratio Ն30 mg/g. Participants were categorized by renal function: no CKD (eGFR Ն60 mL/min/1.73 m 2 without albuminuria, nϭ21 081), stage 1 to 2 CKD (eGFR Ն60 mL/min/1.73 m 2 with albuminuria nϭ2938), stage 3 CKD (eGFR 30 to 59 mL/min/1.73 m 2 , nϭ2683) and stage 4 to 5 CKD (eGFR Ͻ30 mL/min/1.73 m 2 , nϭ215). The prevalence of AF among participants without CKD, and with stage 1 to 2, stage 3, and stage 4 to 5 CKD was 1.0%, 2.8%, 2.7% and 4.2%, respectively. Compared with participants without CKD, the age-, race-, and sex-adjusted odds ratios for prevalent AF were 2.67 (95% confidence interval, 2.04 to 3.48), 1.68 (95% confidence interval, 1.26 to 2.24) and 3.52 (95% confidence interval, 1.73 to 7.15) among those with stage 1 to 2, stage 3, and stage 4 to 5 CKD. The association between CKD and prevalent AF remained statistically significant after further multivariable adjustment and was consistent across numerous subgroups. Conclusions-Regardless of severity, CKD is associated with an increased prevalence of AF among US adults. (Circ Arrhythm Electrophysiol. 2011;4:26-32.)

SummaryBackground and objectives It has been suggested that moderate reductions in estimated GFR (eGFR) among older adults may not reflect chronic kidney disease (CKD).Design, setting, participants, & measurements We examined age-specific (Ͻ60, 60 to 69, 70 to 79, and Ն80 years) associations between eGFR level and six concurrent CKD complications among 30,528 participants from the National Health and Nutrition Examination Survey (NHANES) 1988(NHANES) to 1994(NHANES) and 1999(NHANES) to 2006 (n ϭ 8242 from NHANES 2003 to 2006 for hyperparathyroidism). Complications included anemia (hemoglobin Ͻ12 g/dl women, Ͻ13.5 g/dl men), acidosis (bicarbonate Ͻ22 mEq/L), hyperphosphatemia (phosphorus Ն4.5 mg/dl), hypoalbuminemia (albumin Ͻ3.5 mg/dl), hyperparathyroidism (intact parathyroid hormone Ն70 pg/ml), and hypertension (systolic/diastolic BP Ն140/90 mmHg or antihypertensive use).Results Among participants Ն80 years old, compared with those with estimated GFR (eGFR) Ն60 ml/min per 1.73 m 2 , the multivariable adjusted prevalence ratios (95% confidence interval) associated with eGFR levels of 45 to 59 and Ͻ45 ml/min per 1.73 m 2 were 1.39 (1.11 to1.73) and 2.06 (1.59 to 2.67) for anemia, 1.33 (0.89 to 1.98) and 2.47 (1.52 to 4.00) for acidosis, 1.11 (0.70 to 1.76) and 2.16 (1.36 to 3.42) for hyperphosphatemia, 2.04 (1.39 to 3.00) and 2.83 (1.76 to 4.53) for hyperparathyroidism and 1.09 (1.03 to 1.14), and 1.12 (1.05 to 1.19) for hypertension, respectively. Higher prevalence ratios for these complications at lower eGFR levels were also present at younger ages. Reduced eGFR was associated with hypoalbuminemia only for adults Ͻ70. ConclusionsReduced eGFR was associated with a higher prevalence of several concurrent CKD complications, regardless of age.

Higher saturated fat intake is significantly associated with the presence of high albuminuria, but neither total nor other subtypes of dietary fat are associated with high albuminuria or eGFR <60 mL · min(-1) · 1.73 m(-2).